Purim
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ALZHEIMER’S DISEASE: RISKS
This is never an easy topic to discuss with carers as they quite rightly feel some responsibility and above all would like the ideal solution, a totally safe environment for their loved one. There are few ideal solutions, however, and carers need to discuss the concept of risk taking with the professionals who are asking their relative to take those risks. Some risk factors can be minimized, others (accidents, sudden illness, etc.) cannot. People with confusion still have rights and the right to be at home with acceptable risks is one of them.
Measures can be taken to minimize areas of concern, often following a home visit or after talking to carers, and difficult areas can be highlighted. Homes should be well lit, warm (with automatic heating) and no open fires or very hot surfaces such as old-style radiators. Stairs should ideally have double rails and floors should not be covered with the appropriately called slip-mats. Worn or loose carpet should be removed. Doors should be secure and lock well, with a carer/neighbour keeping a spare set of keys. Walking areas should be as uncluttered as possible so that sticks and zimmer frames do not cause a fall. Footwear must fit properly. Medication should be supervised or the daily requirements left by a carer and all other medication locked away. Appliances that may be dangerous should be disconnected unless the person is safe in using them. It is obvious that not all possible mishaps can be predicted but close liaison between all parties concerned should decrease worries considerably.
A person suffering from physical as well as mental frailty may benefit from ‘one room living’, the concept of all of one’s living needs being supplied close together. The designated room could contain bed, commode, chair, TV/radio, be well heated and made as safe as possible.
Wandering can be a particular problem, either wandering from an elderly person’s own home or from an institution. Some people wander for a reason, e.g. trying to find someone or something. Frequent reassurance or photographs may help. Aimless wandering or simply getting lost causes carers great and understandable stress. The fact is that most elderly people who wander tend not to come to any harm. A few do however: they have road accidents, serious falls, or suffer and occasionally die from exposure. As with most elderly people they are unlikely to be mugged, though obviously thefts or personal violence can occur.
There is great controversy over the concept of ‘tagging’ wanderers (the fitting of a small device in clothing or shoes that triggers an alarm on passing through an external door). They can sometimes be used to locate someone outside. Many people feel that tagging deprives sufferers of some of their human rights and is demeaning. My personal view is that it must never be used as a substitute for adequate staffing and general care but that in a few cases with adequate discussion and agreement there may be a place for it.
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